8 Pregnancy Symptoms You Should Never Ignore

Your body goes through big-time, new-to-you changes when you’re expecting. And while, of course, you know that some discomfort and wonky side-effects are par for the pregnancy course, it’s only natural to wonder: Are these bad pregnancy symptoms—or just part of the process?

The truth is, knowing the difference between concerning pregnancy symptoms and the everyday sensations of carrying a baby is tricky. And knowing when to call your healthcare provider? That can feel even trickier. But here’s the thing to remember: Your doctor or midwife wants to hear from you! Really. They would much rather answer a million false alarms than miss one serious pregnancy symptom. To help you navigate this journey with confidence, here’s your guide to understanding which pregnancy warning signs and pregnancy red flags deserve immediate attention.

Sudden or Severe Swelling

Some swelling during pregnancy is totally normal—you’ll probably notice it most in your feet and ankles. That’s because your body’s cranking out about 50 percent more blood and bodily fluids than usual to support your growing baby. Lying down and elevating your feet above your heart helps ease the swelling. “However, if you experience sudden or severe swelling, especially in your hands, face, legs, ankles or feet late in your second trimester or during your third trimester, you need to see your doctor right away,” says Kelly Culwell, MD, MPH, a board-certified ob-gyn in San Diego, California. This type of swelling can signal serious concerns like preeclampsia, a condition that causes dangerously high blood pressure during pregnancy. This is especially important for Black and Hispanic moms-to-be to keep in mind, since they face a higher risk of developing preeclampsia than other expectant parents.

Equally concerning is swelling that comes with redness and pain—or appears in just one leg. “Swelling in one leg and not the other can be a sign of a potential blood clot, called deep vein thrombosis,” says Jessica Brumley, CNM, PhD, president of the American College of Nurse Midwives and director of midwifery at the University South Florida College of Medicine. “This is a very dangerous pregnancy complication—and it’s even more common in the postpartum period.” (This type of blood clot can travel to the lungs and become life-threatening.) If you notice these symptoms, contact your healthcare team right away. And, remember, any time you’re worried about swelling, don’t hesitate to reach out to your provider.

Severe Headache

In the first trimester, hormone changes can trigger headaches, while the physical demands of carrying your growing baby—and the whole not-sleeping-great situation—can bring them on later. While extremely annoying, these types of headaches can usually be safely treated with acetaminophen (Tylenol), according to the American College of Obstetricians and Gynecologists (ACOG).

That said, an annoying headache becomes a worrisome one if it doesn’t go away with over-the-counter pain medications—and/or if your head pain feels different than what you’ve experienced before pregnancy. “This is especially true after 20 weeks,” says Culwell, noting that a persistent and med-resistant headache at this point in pregnancy can point to preeclampsia, which is associated with high blood pressure and can lead to eclampsia or seizures. “If you’re experiencing this, you should contact your healthcare provider for evaluation,” advises Culwell. And make it quick if your pregnancy headache is accompanied by any of these symptoms:

• Changes in speaking or thinking
• Changes in vision
• Light sensitivity
• Weakness
• Stiff neck
• Fever

“If your headache wakes you from sleep, you should contact your healthcare provider right away, too,” adds Culwell.

Spotting or Bleeding

Up to 25 percent of all moms-to-be experience some bleeding or spotting during pregnancy, particularly in the first trimester. The cause is often harmless—such as when the embryo implants into the uterus (implantation bleeding), hormonal change or spotting after intercourse thanks to an extra-soft cervix. But just because spotting can be harmless doesn’t mean you shouldn’t tell your doctor or midwife. In fact, it’s essential that you do so! “Bleeding or spotting in pregnancy is always something that should be evaluated,” says Culwell. In early pregnancy, bleeding can be a sign of miscarriage or an ectopic pregnancy (pregnancy outside of the uterus, such as in the fallopian tube), which can be life-threatening if untreated. Later on, bleeding might indicate preterm labor or issues with the placenta.

If you experience bleeding or spotting anytime during pregnancy, let your care team know. And, head to the emergency room immediately if your bleeding is:

• Heavy
• Accompanied by belly or pelvic pain
• Includes cramping
• Causes you to feel dizzy

Fever

Before pregnancy, you might have shrugged off a fever with some rest and time. But now that you’re expecting, your rising temperature needs immediate attention—especially in the first trimester. “Fever during early pregnancy can be associated with birth defects such as spina bifida, heart problems or cleft palate—particularly if left untreated,” says Culwell. A fever might also signal infections that could harm baby or, later in pregnancy, increase your risk of preterm labor.

In pregnancy, a temperature of 100.4 degrees Fahrenheit or higher is considered a fever, and a reading above 102 degrees Fahrenheit requires urgent care. Your doctor or midwife may recommend acetaminophen (Tylenol) to lower your temperature or prescribe antibiotics if they suspect a bacterial infection. If you have a fever while pregnant, don’t wait it out—contact your provider pronto.

Painful Urination

If you’re pregnant and are experiencing the tell-tales of a urinary tract infection, like painful urination, blood in your pee or an uptick in urgency, put down that cranberry juice “cure” and call your physician. Your healthcare provider will test and treat your bladder infection (UTI), and help prevent progression to a kidney infection, which often requires hospital treatment with IV antibiotics during pregnancy, says Culwell. Getting immediate treatment is super-important because kidney infections in pregnancy are associated with an increased risk of preterm labor, blood infection (sepsis) and even permanent kidney damage. While any UTI symptoms warrant a call to your doctor or midwife, seek immediate care if you develop these signs of a potential kidney infection:

• Fever
• Back pain
• Chills
• Nausea or vomiting

Trouble Breathing

Pregnancy can quite literally take your breath away. A surge in the hormone progesterone causes you to breathe more deeply, often making you feel like you’re working overtime to get air in. Plus, as your belly grows, your baby-to-be puts the squeeze on your diaphragm, making inhaling even more challenging. “All of that is normal, particularly with exertion,” says Culwell. But just because this is a common pregnancy symptom doesn’t mean you should across-the-board ignore shortness of breath in pregnancy. If your breathing difficulty is severe, or associated with pain, coughing, wheezing or heart palpitations—or if it becomes suddenly worse, especially at rest, “immediately contact your healthcare provider,” says Culwell. These may be signs that something other than pregnancy is causing your breathing problems.

Sudden Weight Gain

Every pregnancy journey is unique, including the pattern of weight gain. If you start at a “normal” weight, you’ll typically put on roughly a pound a week during the second and third trimester, totaling between 25 and 35 pounds over nine months of pregnancy, according to ACOG. (For twin pregnancies, the range is between 31 and 50 pounds.)

Gradual weight gain throughout pregnancy is expected and healthy, but when the weight comes on very quickly, it can be worrisome. “Sudden, large weight gain, particularly late in your second trimester or during your third trimester, could be due to water retention—but it could also be a sign of preeclampsia,” says Culwell. This condition occurs when damaged blood vessels allow more water to leak into—and remain in—your tissue, leading to rapid weight gain. If you put on more than 3 to 5 pounds within a week, contact your healthcare provider. Be especially mindful of other preeclampsia warning signs, including high blood pressure, nausea, headaches and dizziness, advises Brumley.

Feeling Depressed

Real talk: Pregnancy can be an emotional roller coaster. Hormones! Big life changes! Morning sickness! With all that’s happening in your body and life, it’s perfectly normal for your emotions to feel like they’re doing somersaults. And, as ACOG reassures, feeling blue occasionally during pregnancy is completely normal. However, it’s important to pay attention when you experience any of these symptoms for two weeks or more:

• Depressed mood most of the day, nearly every day
• Loss of interest in work or other activities
• Feelings of guilt, sadness, hopelessness or worthlessness
• Too much sleep or trouble sleeping
• Constant tiredness or low energy
• Poor appetite, weight loss—or increased appetite and weight gain
• Difficulty concentrating or making decisions
• Noticeable restlessness
• Thoughts about death or harming yourself

These persistent symptoms may signal prenatal depression, a serious but treatable condition. While depression in pregnancy can affect anyone, certain factors may increase your risk, per Cleveland Clinic: A personal family history of mental illness, anxiety, mood or panic disorders might make you more vulnerable. Your risk might also be higher if you’re carrying multiples, facing pregnancy after infertility, or learning your baby has health challenges. Lacking support from a partner or going through other major life stresses during pregnancy can also play a role.

Know that prenatal depression affects about 1 in 10 moms-to-be, so you are in no way alone here. If you notice any of these signs, reach out to your healthcare provider. Early treatment during pregnancy can help prevent postpartum depression. You deserve support, and help is available.

Decreased Fetal Movement

Those little baby kicks and rolls are more than just sweet moments—they’re reassurance that your baby-to-be is doing well. While it’s true that a moving baby is a healthy baby, unborn babies can sleep for up to 40 minutes at a time, so constant movement shouldn’t be expected, notes Brumley. That said, by the third trimester, you’ll likely notice distinct patterns in baby’s activity levels throughout the day. “If you’re concerned that baby isn’t moving as much as usual, I recommend eating something sweet or drinking something cold to stimulate movement,” says Brumley.

You can also lie on your left side and/or walk around for five minutes. Next, pay attention to baby for about an hour. (Learn how to kick count.) If the movement picks up, great—maybe you were just distracted. If after two hours you haven’t felt 10 movements, go ahead and get your doctor or midwife on the line. Do this even if your at-home fetal doppler reassures with a heartbeat. (These devices are ill advised for a reason.) Instead, let your care team decide if more monitoring is needed. “You may need to come in for a nonstress test, where we listen to baby’s heart rate for 20 minutes, or an ultrasound to evaluate fetal well-being,” says Brumley.

Summary Takeaway

It’s not always easy to distinguish between normal pregnancy symptoms and pregnancy warning signs that need attention. Remember: You know your body best. If a symptom feels severe, persists or just doesn’t seem right, don’t hesitate to reach out to your provider. “Ideally, I encourage people to find a care team that they trust,” says Brumley. “You shouldn’t have to feel like you’re advocating for yourself, but rather that you have a team that’s advocating for you.” If you’re unsure about a symptom or situation, bring a support person to your appointments and don’t be afraid to ask questions—lots of questions! Brumley says that “above all else, always listen to your intuition!”

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.